Berglund, Jason R
Berglund, Jason R is an individual health care provider with primary practice located at 6050 Tacoma Mall Blvd Ste 300 , Tacoma WA 98409-6828. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Berglund, Jason R can be contacted via phone (253) 851-5200.Contact Information
Primary practice address
6050 Tacoma Mall Blvd Ste 300
Tacoma WA 98409-6828
Phone: (253) 851-5200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | 36002146A | Indiana |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | 096.002661 | Illinois |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | A160590112 | Washington |
Profile Details
| NPI number | 1750668141 |
|---|---|
| LBN Legal business name | Berglund, Jason R |
| Credentials | Athletic Trainer, Certified (ATC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 14th, 2011 |
| Last updated | Aug 13th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750668141 | NPPES |
| Washington | Other | A160590112 | WASHINGTON STATE DEPARTMENT OF HEALTH - ATHLETIC TRAINER LICENSE |
| Washington | Other | 090702258 | WASHINGTON STATE DEPARTMENT OF HEALTH - ATHLETIC TRAINER LICENSE |
| Washington | Other | 36002146A | WASHINGTON STATE DEPARTMENT OF HEALTH - ATHLETIC TRAINER LICENSE |
| Washington | Other | 096.002661 | WASHINGTON STATE DEPARTMENT OF HEALTH - ATHLETIC TRAINER LICENSE |
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